CHDP DIRECTOR/DEPUTY DIRECTOR TRAINING SECTION II References and State Correspondence 1 7/1/2010
CHDP DIRECTOR/DEPUTY DIRECTOR TRAINING SECTION II References and State Correspondence 1 7/1/2010.
Dec 17, 2015
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CHDP DIRECTOR/DEPUTY DIRECTOR TRAINING SECTION II
References and State Correspondence
1
7/1/2010
Program Websites / List Serve
7/1/2010
2
CMS Website3
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CHDP Website
The CHDP Website is the central location to find information about the CHDP Program.
4
7/1/2010
CMS Branch Notification Mailing List
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A mailing list has been created to allow Children's Medical Services (CMS) stakeholders to receive CMS Net system alerts, This Computes!, and letters from the CMS Branch.
To join or leave the DHCS CMS Branch Stakeholder notice mailing list go to the CHDP Program Letters and Provider Information Notices page and click on the link LISTSERV Subscription Page and fill out your information.
You will receive a welcome email with information confirming your subscription to the list and instructions on how to leave the list.
It is really quite handy, convenient and informational! 7/1/2010
Plan and Fiscal Guidelines
7/1/2010
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Plan and Fiscal Guidelines (PFG)
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Document issued by State CMS and updated annually
Available electronically at the CHDP website: www.dhcs.ca.gov/services/chdp
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Plan and Fiscal Guidelines8
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Plan and Fiscal Guidelines9
Contains descriptions of CMS organization and programs
Provides directions on submission of Annual Plans, Budgets and Performance Measure reporting
Gives template and directions for Memoranda of Understanding (MOUs) and Interagency Agreements (IAAs)
7/1/2010
Plan and Fiscal Guidelines10
Gives detailed instruction on budget preparation
Provides instruction on claim preparation and property management
Gives information, instruction and forms to be used for time studying for Federal Financial Participation
7/1/2010
Plan and Fiscal Guidelines11
The References section contains a variety of supporting documents, regulations, and forms. CHDP Staffing Matrix Legislation and Regulations for CHDP Program Legislation and Regulations for HCPCFC State Laws Relating to HCPCFC CHDP Pre-Enrollment Application (DHCS 4073) CHDP Referral (PM 357) Confidential Screening/Billing Report Forms (PM
160) Confidential Referral/Follow-Up Report (PM 161)
7/1/2010
Plan and Fiscal Guidelines12
Appendix Contains “The Essential Services of Public
Health and Ten Essential Public Health Services to Promote Child Health in America”
Data Guide Abbreviations and Acronyms Optional Annual School Report Form
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Regulations13
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Regulations14
A listing of the regulations that pertain to both the CHDP and HCPCFC programs can be found in the References section of the Plan and Fiscal Guidelines.
It includes a brief topic description and the location of the specific regulation, by code name and section.
7/1/2010
Regulations15
The full text of the regulations can be found at www.leginfo.ca.gov
At this site, select California law, then select the appropriate code and hit the search key to reach the table of contents for that specific code.
User can navigate between sections from the table of contents page.
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CMS Directory16
CHILDREN’S MEDICAL SERVICES DIRECTORY
Children’s Medical Services Branch Department of Health Care Services State of California
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CMS Directory17
A directory of State staff and key local program staff is available on-line at the CHDP website at http://www.dhcs.ca.gov/formsandpubs/publications/Documents/CMS/CMSDirectory.pdf
The directory includes names, position titles, phone numbers, addresses and fax numbers.
7/1/2010
CMS Directory18
A password is needed to access the site. Password: CMS#directory Note: Password is case sensitive Send changes to email address:
[email protected] a cc: to the Regional Nurse
Consultant
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Local Program Guidance Manual
19
7/1/2010
Local Program Guidance Manual (LPGM)
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The Local Program Guidance Manual is a State document that provides direction to the local program on the procedures for: Approving Providers Denying Providers Conducting Site Reviews Handling Appeals
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Local Program Guidance Manual
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Maintaining Provider Charts Provider Performance Improvement Problem Resolution Provider Disenrollment Notifying CMS Branch of Provider Info
CHDP Provider Data Sheet (PM 177) Computer Media Claiming
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Local Program Guidance Manual
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The LPGM can be found on the CHDP website under the Local CHDP Programs section.
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Local Program Guidance Manual
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7/1/2010
Local Program Guidance Manual
24
A password is needed to access the Manual.
Password: CHDP#LPGM
Password is case sensitive.
7/1/2010
Business Objects Reports
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Business Objects 26
Data reports for the CHDP program can be accessed online.
A user ID and password is needed.
Password must be changed every 60 days.
The Form used to request access can be found at the CHDP website, select Business Objects under the Local CHDP Programs heading on the CHDP home page.
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Business Objects27
A Business Objects User Guide is posted on the CHDP website on the Business Objects page.
Training on Business Objects is available. Contact your Regional Nurse Consultant for more information.
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Business Objects28
Ad hoc reports cannot be run with CHDP data. Only corporate reports are available.
Cut and Paste can be used to transfer the data into Excel for manipulation.
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Business Objects29
Examples of some report titles are: CHDP Monthly Summary of Screens by
Funding Source for Month of ____ Number of CHDP Claims by Age Group Number of CHDP Claims by County, Age
and Funding Source CHDP Gateway No Enrollments by Provider Active CHDP Providers by Provider County
and Provider Name
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Information Notices30
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Information Notices
31
The State CMS branch communicates through several different types of correspondence.
Information notices are sent electronically to convey information to local programs, branch and regional office staff.
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Information Notices32
The information conveyed in Information Notices is general information, resources or announcements for effective management of the program.
These notices do not describe CHDP program policy.
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Information Notices33
CHDP Information Notices pertain only to the CHDP Program.
CMS Information Notices pertain to both the CHDP and CCS Programs.
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Information Notices34
Information Notices can be found on the CHDP Website. Click on Letters under the Local CHDP Programs heading, then select either CHDP or CMS Information Notices.
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Information Notices35
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CHDP Program Letters36
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CHDP Program Letters37
CHDP Program Letters are policy specific and sent electronically to local programs, regional offices and branch staff to provide specific information about CHDP Program policy.
Program Letters can be found at the CHDP website.
Program Letters always accompany Provider Information Notices.
7/1/2010
Provider Information Notices (PIN)
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CHDP Provider Information Notices contain program updates, training opportunities and other program related information for Providers and Medi-Cal Managed Care plans. Provider Information Notices are sent to each local office via email along with a CHDP Program Letter. Each local office is responsible for ensuring PINs are distributed to enrolled providers.
PINs can be accessed from the Providers and Partners section on the CHDP website.
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CHDP Provider Manual and Bulletins39
7/1/2010
CHDP Provider Manual and Bulletins
40
The Provider Manual is the primary billing reference for the CHDP program and should be consulted before referring to other sources of information. This manual also contains policies and procedures of the CHDP program.
The Manual can be found on, and printed from, the CHDP website.
7/1/2010
CHDP Provider Manual and Bulletins
41
The Provider Manual is designed as a reference manual
document and contains basic information about: How to enroll as a CHDP provider CHDP provider responsibilities Services that can be provided to eligible
children and youth How to enroll children and youth through the
CHDP Gateway How to be reimbursed for CHDP program
services How to complete the Confidential
Screening/Billing Report (PM 160) claim form 7/1/2010
CHDP Provider Manual and Bulletins
42
CHDP Provider Bulletins are updates and revisions to the CHDP Provider Manual and should be incorporated into the manual.
It is important to replace the outdated pages in the manual with the revisions as indicated in the bulletin.
To maintain a current manual, pages should be updated as soon as possible according to bulletin instructions.
Unless otherwise noted, you are not required to retain prior issues of the bulletin.
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CHDP Provider Bulletins43
You may view the CHDP Provider Bulletins containing articles and manual pages with the latest program, policy and billing information on the CHDP Website under the CHDP Provider Manual link. Article information is typically included in the revised manual pages.
7/1/2010
Health Assessment Guidelines
7/1/2010
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Health Assessment Guidelines
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The Guidelines: Set a standard for pediatric health
assessments for children served by the CHDP Program
Include the frequency of the exam, the definition of the tests to be provided and recommendations for anticipatory guidance
Include recommended criteria for appropriate referrals to diagnosis and treatment
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Health Assessment Guidelines
46
Updates can be found on the CHDP website under the Publications link.
Please note - Guidelines are under revision and will be available online in the future. In the meantime, contact your Regional Nurse Consultant if you need a copy.
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County/City Surveillance Data
47
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Pediatric Nutrition Surveillance System (PedNSS)48
PedNSS is a program-based surveillance system that monitors the nutritional status of low-income infants and children, and women in federally funded maternal and child health programs. Statistics available include info on: Underweight Overweight Obesity Anemia
The data can be used for program planning, management, and evaluation; for the development of health and nutrition interventions; and to monitor progress toward the Healthy People 2010 objectives for the United States.
PedNSS data can be found on the CHDP website at the County Surveillance Data link.
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PedNSS Table
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PedNSS50
Local CHDP programs use County/City PedNSS reports with other agencies and organizations for the purposes of informing and promoting appropriate community and healthcare responses to the prevalence of childhood overweight.
PedNSS data is required for CHDP Performance Measure 5: Identification of the prevalence rate of overweight children in a “critical group” according to the PedNSS Annual Report and description of local program use of PedNSS reports in healthcare and community venues.
7/1/2010
County Asthma Profile51
The County Asthma Profile is a county-specific asthma data resource for each of the 58 counties in California.
Individual data for every county as well as county comparisons can be found at http://www.californiabreathing.org/
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County Asthma Profile52
7/1/2010
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